Gestational Diabetic Women Research Articles

Point: Oral Hypoglycemic Agents Should Not Be Used to Treat Diabetic Pregnant Women

Studies in pregnancy indicate that the most important glucose concentration throughout the day is the peak postprandial glucose response; i.e., it is the highest blood glucose of the day, not the average, that predicts risk of untoward effects. The Diabetes in Early Pregnancy (DIEP) Study was a multicenter, case-controlled trial of type 1 diabetic women compared with healthy control women throughout pregnancy. Along with the primary objective of relating maternal glucose to risk of spontaneous abortions and malformations, they also studied the relationship between maternal postprandial glucose concentrations and risk of neonatal macrosomia (1). The DIEP Study identified 28.5% of infants from diabetic mothers who were above the 90th percentile of infant birth weight. Birth weight correlated positively with first-trimester maternal fasting blood glucose and A1C. When adjusted for fasting blood glucose and A1C, the 1-h postprandial maternal blood glucose concentration in the third trimester was an even stronger predictor of infant birth weight and fetal macrosomia. In addition, they reported that the risk of macrosomia is a continuum. They showed that any postprandial glucose peak was associated with an increased risk of macrosomia above the 10% risk seen in the general population. Combs et al. (2) confirmed the findings of the DIEP Study and added the observation that elevated postprandial glucose was associated with an increased rate of macrosomia when higher maternal postprandial glucose concentrations were observed between weeks 29 and 32 of gestation. In a study of gestational diabetic women who failed a trial of diet and thus required insulin therapy, De Veciana et al. (3) described improved fetal outcome with less risk of neonatal hypoglycemia, macrosomia, and Caesarean delivery in women with gestational diabetes mellitus (GDM) when the women were managed by controlling 1-h postprandial glucose concentrations as opposed to action only based on preprandial glucose concentrations. …

Serum Selenium Concentrations Correlate Significantly with Inflammatory Biomarker High-sensitive CRP Levels in Hungarian Gestational Diabetic and Healthy Pregnant Women at Mid-pregnancy

Selenium is an essential trace element and a component of various enzymes with antioxidant functions. High-sensitive C-reactive protein (hsCRP) is an early indicator of increased lipid peroxidation. The serum selenium concentration, lipid parameters, and hsCRP values of gestational diabetic pregnant women (GD), control pregnant women (CP), and healthy nonpregnant controls (HC) were compared. Blood was taken between the 24th and the 28th week of pregnancy when the oral glucose tolerance test was performed. Selenium concentration was determined by atomic absorption spectrometry after hydride generation. HsCRP was measured by immunturbidimetry. HC had significantly higher serum selenium concentrations than GD and CP women (HC = 77.4 +/- 14.82, GD = 51.7 +/- 11.62, and CP = 40.5 +/- 8.03 microg/l, respectively). HsCRP values of both GD and nondiabetic pregnant women were significantly higher compared to controls. Significant negative correlations were found between serum selenium and total cholesterol, low-density lipoprotein cholesterol, and hsCRP values indicating that low selenium levels are associated with increased lipid peroxidation. Serum selenium concentrations of Hungarian pregnant women are low compared to internationally published data.

OC03: Fetal weight estimation in gestational diabetic pregnant women: comparison between conventional and a new three‐dimensional ultrasound method

OC03: Fetal weight estimation in gestational diabetic pregnant women: comparison between conventional and a new three‐dimensional ultrasound method

Increased Incidence of Gestational Diabetes in Women Receiving Prophylactic 17α-Hydroxyprogesterone Caproate for Prevention of Recurrent Preterm Delivery

Progesterone has a known diabetogenic effect. We sought to determine whether the incidence of gestational diabetes mellitus (GDM) is altered in women receiving weekly 17alpha-hydroxyprogesterone caproate (17P) prophylaxis for the prevention of recurrent preterm birth. Singleton gestations in women having a history of preterm delivery were identified from a database containing prospectively collected information from women receiving outpatient nursing services related to a high-risk pregnancy. Included were patients enrolled for outpatient management at <27 weeks' gestation with documented pregnancy outcome and delivery at >28 weeks. Patients with preexisting diabetes were excluded. The incidence of GDM was compared between patients who received prophylactic intramuscular 17P (250-mg weekly injection initiated between 16.0 and 20.9 weeks' gestation) and those who did not. Maternal BMI and age were similar. The incidence of GDM was 12.9% in the 17P group (n = 557) compared with 4.9% in control subjects (n = 1,524, P < 0.001; odds ratio 2.9 [95% CI 2.1-4.1]). The use of 17P for the prevention of recurrent preterm delivery is associated with an increased risk of developing GDM. Early GDM screening is appropriate for women receiving 17P prophylaxis.

Antioxidant status and circulating lipids are altered in human gestational diabetes and macrosomia

Fetuses from mothers with gestational diabetes are at increased risk of developing neonatal macrosomia and oxidative stress. We investigated the modulation of antioxidant status and circulating lipids in gestational diabetic mothers and their macrosomic babies and in healthy age-matched pregnant women and their newborns. The serum antioxidant status was assessed by employing anti-radical resistance kit (KRL; Kirial International SA, Couternon, France) and determining levels of vitamin A, C, and E and the activity of superoxide dismutase (SOD). Circulating serum lipids were quantified, and lipid peroxidation was measured as the concentrations of serum thiobarbituric acid-reactive substances (TBARS). As compared with non-diabetic mothers, gestational diabetic women exhibited decreased levels of vitamin E and enhanced concentrations of vitamin C without any changes in vitamin A. Vitamin A and C levels did not change in macrosomic babies except vitamin E whose levels were lower in these infants than in the newborns of non-diabetic mothers. Gestational diabetes mellitus (GDM) and macrosomia were also associated with impaired SOD activities and enhanced TBARS levels. Globally, total serum antioxidant defense status in diabetic mothers and their macrosomic babies was diminished as compared with control subjects. Triglyceride and cholesterol concentrations did not differ significantly between gestational diabetic and control mothers; however, macrosomia was associated with enhanced plasma cholesterol and triglyceride levels. These results suggest that human GDM and macrosomia are associated with downregulation of antioxidant status, and macrosomic infants also exhibit altered lipid metabolism.

Pregnancy outcome in obese and morbidly obese gestational diabetic women

Objective We sought to determine whether pregnancy outcome differs between obese and morbidly obese GDM patients and to assess pregnancy outcome in association with mode of treatment and level of glycemic control. Methods A cohort study of 4830 patients with gestational diabetes (GDM), treated in the same center using the same diabetic protocol, was performed. Obesity was defined as prepregnancy BMI >30 and <35 kg/m 2; morbid obesity was defined as prepregnancy BMI ≥35 kg/m 2. Well-controlled GDM was defined as mean blood glucose <105 mg/dl. Pregnancy outcome measures included the rates of large for gestational age (LGA) and macrosomic babies, metabolic complications, the need for NICU admission and/or respiratory support, rate of shoulder dystocia, and the rate of cesarean section. Results Among the GDM patients, the rates of obesity and morbid obesity were 15.7% (760 out of 4830, BMI: 32.4 ± 1.6 kg/m 2) and 11.6% (559 out of 4830, BMI: 42.6 ± 2.2 kg/m 2), respectively. No differences were found with regard to maternal age, ethnicity, gestational age at delivery or oral glucose tolerance test (OGTT) results. Moreover, similar rates of cesarean section, fetal macrosomia, shoulder dystocia, composite outcome, and metabolic complications were noted. Insulin treatment was initiated for 62% of the obese and 73% of the morbidly obese GDM patients ( P < 0.002). Similar rates of obese and morbidly obese patients achieved desired levels of glycemic control (63% versus 61%, respectively). In both obese and morbidly obese patients who achieved a desired level of glycemic control (<105 mg/dl), no difference was found in pregnancy outcome except that both neonatal metabolic complications and composite outcomes were more prevalent in diet-treated subjects in comparison to insulin-treated GDM patients. Conclusion In obese women with GDM, pregnancy outcome is compromised regardless of the level of obesity or treatment modality.

The pregnancy-induced increase of plasma angiotensin-(1–7) is blunted in gestational diabetes

Background and objective It has been shown that the circulating Renin–Angiotensin System (RAS) is activated during normal pregnancy, but little is known about RAS in pregnancies complicated by gestational diabetes (GDM). GDM is considered not merely a temporary condition, but a harbinger of hypertension and type 2 diabetes. The aim of this study was to evaluate the circulating RAS profile in normotensive women with GDM at the third trimester of pregnancy and to compare the results with healthy pregnant and non-pregnant age-matched women. Methods The diagnostic criteria for GDM followed the recommendations of the American Diabetes Association. Angiotensin I (Ang I), Angiotensin II (Ang II) and Angiotensin 1–7 [Ang-(1–7)] were determined in 24 pregnant patients with GDM; 12 healthy pregnant women and 12 non-pregnant women by radioimmunoassay. Results Levels of Ang I, Ang II and Ang-(1–7) were higher in pregnant women ( p < 0.05), but showed a different pattern in the GDM group, in which reduced Ang-(1–7) circulating levels were found ( p < 0.05). This observation was confirmed by the significantly lower Ang-(1–7)/Ang I ratio ( p < 0.05). Conclusion Our data suggest that reduced levels of the vasodilator Ang-(1–7) could be implicated in the endothelial dysfunction seen in gestational diabetic women during and after pregnancy.

Engaging the Consumer through Event Marketing: Linking Attendees with the Sponsor, Community, and Brand

<h3>Objectives</h3> To investigate the impact of maternal age on pregnancy outcomes with special emphasis on adolescents and older mothers and to investigate the differences in demographic profile between adolescents and older mothers. <h3>Methods</h3> This study is a secondary analysis of pregnancy outcomes of women in Riyadh Mother and Baby cohort study according to maternal age. The study population was grouped according to maternal age into five subgroups; &lt;20, 20–29, 30–34, 35–39 and 40+years. The age group 20–29 years was considered as a reference group. Investigation of maternal age impact on maternal and neonatal outcomes was conducted with adjustment of confounders using regression models. <h3>Results</h3> All mothers were married when conceived with the index pregnancy. Young mothers were less likely to be illiterate, more likely to achieve higher education and be employed compared with mothers ≥ 40 years. Compared with the reference group, adolescents were more likely to have vaginal delivery (and least likely to deliver by caesarean section (CS); OR=0.6, 95% CI 0.4 to 0.9, while women ≥40 years, were more likely to deliver by CS; OR 2.9, 95% CI 2.3 to 3.7. Maternal age was a risk factor for gestational diabetes in women ≥40 years; OR 1.7, 95% CI 1.3 to 2.1. Adolescents had increased risk of preterm delivery; OR 1.5, 95% CI 1.1 to 2.1 and women ≥40 years had similar risk; OR, 1.3, 95% CI 1.1 to 1.6. <h3>Conclusion</h3> Adverse pregnancy outcomes show a continuum with the advancement of maternal age. Adolescents mother are more likely to have vaginal delivery; however, they are at increased risk of preterm delivery. Advanced maternal age is associated with increased risk of preterm delivery, gestational diabetes and CS.

Intrauteriner Tod des Feten bei präkonzeptionellem Diabetes, Gestationsdiabetes und Schwangerschaften ohne diabetische Stoffwechsellage. Ergebnisse der Perinatalstatistik Niedersachsen

The prevalence of intrauterine fetal death as well as the relevant risk factors in pregnancies of women with preconceptional and gestational diabetes mellitus and non-diabetic women were investigated. The data of the Perinatal Registry of Lower Saxony between 1987 and 1999 for pregnancies of women with preconceptional diabetes mellitus (PDM, n = 3351), gestational diabetes mellitus (GDM, n = 3954) and women without diabetes mellitus (non-diabetic pregnancies, NDM, n = 887,779) were retrospectively analysed. Intrauterine fetal death occurred in 46 women with PDM (1.35 %), 32 women with GDM (0.79 %) and 2756 non-diabetic women (0.31 %). The odds ratio (OR, 95 % CI) for PDM vs. NDM was 4.468 (3.332 - 5.992; p < 0.01) and for GDM vs. NDM it was 2.595 (1.829 - 3.682; p < 0.01). The percentage of death, which occurs before the 32nd week of gestation, was 13 % in pregnancies with PDM, 12.5 % in pregnancies with GDM and 27.7 % in non-diabetic pregnancies. 50 % of fetal deaths in the PDM group, 43.8 % of those in the GDM group and 39.3 % of those in the NDM group occurred after the 36th week of gestation. The percentages of dead fetuses who were under the 10th percentile of growth (small for gestational age, SGA), in pregnancies with PDM, GDM and NDM were 15.2 %, 6.3 %, and 28.7 %, respectively. The percentages of dead fetuses above the 90th percentile of growth (large for gestational age, LGA) were 41.3 % (PDM), 37.5 % (GDM), and 8.7 % (NDM), (p < 0.01 for PDM vs. NDM and for GDM vs. NDM). The risk of intrauterine fetal death in pregnancies of diabetic women is still increased. It seems that especially the LGA fetuses of diabetic mothers and SGA fetuses of non-diabetic mothers are at greater risk of intrauterine death.

Blood ketone monitoring: a comparison between gestational diabetes and non-diabetic pregnant women

To measure ketonemia in a control population of pregnant women and in a population of women with gestational diabetes (GDM). To define a normal ketonemia threshold for the controls and to determine whether or not this value could play a role in the clinical management of women with GDM. Fifty-six women with a normal OGTT and 49 women with GDM were included and monitored from the 25th to the 37th week of pregnancy. Control subjects agreed to perform glycaemia and ketonemia self-monitoring 3 times a day. In addition, women with GDM were asked to measure their postprandial glycaemia. Glycaemia and ketonemia measurements were performed using Optium meters. Subjects kept a 24-hour food record twice a week. The mean ketonemia was lower in the control group than in the GDM group (0.01+/-0.10 vs. 0.04+/-0.009 mmol/l; P<0.001). Ketonemia values measured before the midday meal and prior to the evening meal were lower for control subjects than for GDM patients (P=0.002 and P=0.005). Fasting ketonemia was unrelated to ketonuria in the GDM group, whereas there was a correlation in the control group (P=0.006). At least one chronic increase in ketonemia levels was observed in 47% of the women with GDM, compared with only 12% of controls. The lowest levels of evening glycaemia correlated with the highest levels of ketonemia; women with GDM reported lower food and carbohydrate intakes than controls (P<0.001). This work has enabled the establishment of ketonemia reference standards in non-diabetic pregnant women. If ketonemia does indeed indicate overly restrictive dietary behavior, this parameter could be employed for monitoring adherence to the nutritional recommendations for GDM.

Obese gestational diabetic women: Comparison of insulin and glyburide therapies

Obese gestational diabetic women: Comparison of insulin and glyburide therapies

Modulation of Adipokines and Cytokines in Gestational Diabetes and Macrosomia

Not much is known about the implication of adipokines and different cytokines in gestational diabetes mellitus (GDM) and macrosomia. The purpose of this study was to assess the profile of these hormones and cytokines in macrosomic babies, born to gestational diabetic women. A total of 59 women (age, 19-42 yr) suffering from GDM with their macrosomic babies (4.35 +/- 0.06 kg) and 60 healthy age-matched pregnant women and their newborns (3.22 +/- 0.08 kg) were selected. Serum adipokines (adiponectin and leptin) were quantified using an obesity-related multiple ELISA microarray kit. The concentrations of serum cytokines were determined by ELISA. Serum adiponectin levels were decreased, whereas the concentrations of leptin, inflammatory cytokines, such as IL-6 and TNF-alpha, were significantly increased in gestational diabetic mothers compared with control women. The levels of these adipocytokines were diminished in macrosomic babies in comparison with their age-matched control newborns. Serum concentrations of T helper type 1 (Th1) cytokines (IL-2 and interferon-gamma) were decreased, whereas IL-10 levels were significantly enhanced in gestational diabetic mothers compared with control women. Macrosomic children exhibited high levels of Th1 cytokines and low levels of IL-10 compared with control infants. Serum IL-4 levels were not altered between gestational diabetic mothers and control mothers or the macrosomic babies and newborn control babies. GDM is linked to the down-regulation of adiponectin along with Th1 cytokines and up-regulation of leptin and inflammatory cytokines. Macrosomia was associated with the up-regulation of Th1 cytokines and the down-regulation of the obesity-related agents (IL-6 and TNF-alpha, leptin, and adiponectin).

Mo-W2:5 Increased vascular wall endothelial nitric oxide synthase (ENOS) levels in umbilical cords from gestational diabetic women

Mo-W2:5 Increased vascular wall endothelial nitric oxide synthase (ENOS) levels in umbilical cords from gestational diabetic women

Placental Doppler velocimetry in gestational diabetes mellitus

To evaluate if maternal glucose level and growth of the fetus were related to placental vascular impedance in pregnancy complicated by gestational diabetes mellitus. A retrospective study of 146 gestational diabetic women of which 117 needed insulin therapy. Glycosylated hemoglobin (HbA1c) was evaluated as well as umbilical and uterine artery Doppler velocimetry. The results were related to adverse outcome of pregnancy including newborn birthweight. Abnormal umbilical artery blood flow velocity was seen in 5% of the cases and abnormal uterine artery flow in 16%. Uterine and umbilical artery vascular impedance was significantly lower in macrosomic newborns. There was a poor correlation between HbA1c, vascular impedance and birthweight. There were 11 cases that developed preeclampsia, all having abnormal uterine artery Doppler and two abnormal umbilical artery Doppler. Uterine and umbilical artery vascular impedance in pregnancies complicated by gestational diabetes is related to birthweight and placental weight, but not to maternal HbA1c levels. Placental Doppler ultrasound does not seem to be of clinical value for fetal surveillance in these pregnancies unless the pregnancy is complicated by preeclampsia and/or intrauterine fetal growth restriction.

Impaired β‐cell function in lean normotolerant former gestational diabetic women

Former gestational diabetes (fGDM) constitutes a risk condition for the development of Type 2 diabetes. Former gestational diabetes is often characterized by obesity and hyperglycaemia, which may be concomitant and independent risk factors. To assess insulin sensitivity and beta-cell function in fGDM uncomplicated by obesity and hyperglycaemia, we studied 24 lean fGDM women and 23 control women matched for age (30.7 +/- 0.7 years, whole cohort), body mass index (22.2 +/- 0.3 kg m(-2)), and indistinguishable for plasma glucose both at fasting and at 120 min. Several insulin sensitivity and beta-cell function indices were computed: homeostasis model assessment insulin resistance index (HOMA-R), insulin sensitivity index derived from an oral glucose tolerance test (OGIS), insulinogenic index, other empirical indices of insulin secretion and beta-cell function, and indices obtained using a beta-cell model. Though the majority of indices, and in particular insulin sensitivity (HOMA-R: 1.35 +/- 0.13 vs. 1.65 +/- 0.14; OGIS: 492.7 +/- 6.3 vs. 496.4 +/- 9.4 mL min(-1) m(-2)), were not significantly different in the two groups, the beta-cell glucose sensitivity obtained by modelling analysis was lower in fGDM (108 +/- 14 vs. 165 +/- 22 pmol min(-1) m(-2) mM(-1), P = 0.031). Impairment of beta-cell glucose sensitivity may be an intrinsic risk factor in fGDM independently of obesity and hyperglycaemia. Furthermore, we have shown that modelling analysis, in contrast to the empirical parameters, may be able to detect early beta-cell alterations in fGDM women.

The validity of oral glucose tolerance test after 36 weeks’ gestation

Objective Secretion of anti-insulin hormones plateaus near term, questioning the validity of OGTT (oral glucose tolerance test) during that period. We aimed at assessing the feasibility of OGTT near term as compared to OGTT at 26–32 weeks. Patients and methods One thousand four hundred and eighty seven pregnant women were screened by GCT (glucose challenge test), and 282 (19%) of them performed an OGTT at 26th–32nd weeks (“early” OGTT) after meeting the threshold value for GCT. Forty-one women with abnormal and 16 with normal early OGTT underwent a repeated OGTT at 36–40 weeks’ gestation (“late” OGTT). Blood glucose levels during GCT and OGTT were compared between women with early and late abnormal OGTT and women who converted from early abnormal to late normal OGTT. Results Thirty-six out of 41 participants (88%) with early abnormal OGTT had abnormal test near term as well (Group I). Five women with an early abnormal OGTT converted to normal according to a late OGTT (Group II). These women had lower glucose levels on both late and early OGTT as compared with Group I. All 16 women who tested normal on early OGTT had a consistently normal late OGTT. Glucose levels for all 57 women did not significantly differ between early and late OGTT. The sensitivity, specificity, and positive and negative predictive values of late OGTT were 88%, 100%, 100%, and 76%, respectively. Conclusion The positive predictive value of late OGTT performed at 36–40 weeks’ gestation is 100%. This test may be used to detect gestational diabetes in women near term.

Pregnancy outcome in obese and morbidly obese gestational diabetic women

Obesity was suggested as an independent risk factor on pregnancy outcome in GDM; however no stratification exists between level of obesity and pregnancy outcome in GDM. Thus, we sought to determine if pregnancy outcome is differed in obese and morbid obese GDM patients.

Fetal erythrocyte membrane lipids modification: preliminary observation of an early sign of compromised insulin sensitivity in offspring of gestational diabetic women

Intrauterine exposure to diabetes is a significant determinant of the development of obesity and early onset of Type 2 diabetes mellitus in the offspring. Both conditions are characterized by insulin resistance and the latter is associated with reduced membrane arachidonic and docosahexaenoic acids. Hence, we investigated if the membrane arachidonic and docosahexaenoic acids are depressed in the cord blood of babies born to women with gestational diabetes. Cord (fetal) and maternal blood were obtained at delivery from control subjects (n = 33) and women with gestational diabetes (n = 40) and analysed for plasma triglycerides and cholinephosphoglycerides, and erythrocyte choline- and ethanolaminephosphoglycerides fatty acids. Babies of gestational diabetic mothers had reduced docosahexaenoic acid in the plasma (5.9 +/- 1.4 vs. 7.1 +/- 2.0, P < 0.01) and erythrocyte (4.0 +/- 2.2 vs. 5.4 +/- 2.9, P < 0.05) cholinephosphoglycerides. Moreover, the total omega-6 and omega-3 fatty acids of the erythrocyte cholinephosphoglycerides were significantly lower (P < 0.05) in these babies. A similar trend was observed in plasma triglycerides and erythrocyte ethanolaminephosphoglycerides. The maternal plasma triglycerides and erythrocyte ethanolaminephosphoglycerides fatty acids profile were not different between the two groups. However, there was a reduction in arachidonic acid and total omega-6 fatty acids in the erythrocyte cholinephosphoglycerides of the gestational diabetic women. The altered plasma and erythrocyte fatty acids in the cord blood of babies born to women with gestational diabetes suggests a perturbation in the maternal-fetal nutrient transport and/or fetal lipid metabolism.

Technical standards and guidelines: Prenatal screening for open neural tube defects: This new section on “Prenatal Screening for Open Neural Tube Defects,” together with the new section on “Prenatal Screening for Down Syndrome,” replaces the previous Section H of the American College of Medical Genetics Standards and Guidelines for Clinical Genetics Laboratories

Technical standards and guidelines: Prenatal screening for open neural tube defects: This new section on “Prenatal Screening for Open Neural Tube Defects,” together with the new section on “Prenatal Screening for Down Syndrome,” replaces the previous Section H of the American College of Medical Genetics Standards and Guidelines for Clinical Genetics Laboratories *

Maternal-fetal transport kinetics of L-Leucine in vitro in gestational diabetic pregnancies

Paucity of data relating to transport of amino acids in gestational diabetic pregnancies prompted us to undertake this study. Transport kinetics of a model amino acid, L-leucine was investigated in gestational diabetic pregnancies in vitro, using perfusion of isolated placental lobules. Placentae from diabetic and control pregnant women were collected post-partum. Suitable placental lobules were then perfused, using National Culture and Tissue Collection (NCTC) medium, diluted with Earle's buffered salt solution as perfusate. 14C-labelled L-leucine along with tritiated water as reference were injected as a 100 ul bolus into the maternal circulation and serial perfusate samples collected over a 5-minute study period. In 6 successful perfusions, differential transport rate of L-leucine for 10, 25, 50, 75 and 90% of efflux in the fetal vein averaged 1.17, 1.12, 1.22, 1.20 and 1.17 times respectively that of reference in the diabetic group. In the control group (n=6), leucine transport indices for the corresponding efflux periods averaged 1.13, 1.15, 1.18, 1.17 and 1.16 times respectively that of the reference marker. Student's 't' test showed that the difference between the two groups was not statistically significant (p > 0.05) for all the efflux fractions studied. In the diabetic series, leucine transport fraction (TF) averaged 41.2 +/- 4.5% of corresponding water TF while in control group, the amino acid TF averaged 46.5 +/- 6.5% of water TF. The difference between the two series, however was not statistically significant (p > 0.05). Similarly, kinetic parameters as area under the curve, clearance, elimination constant, time for maximum response, absorption rate, and elimination rate in the diabetic and control groups, were not significantly different (p > 0.05) as well. Our study seems to indicate that transport kinetics of leucine under in vitro conditions, do not differ significantly in placentae of gestational diabetic women compared to controls.